PrepU- Digestion and Nutrition

The nurse reviews national dietary guidelines and healthy eating guide with an older adult client. Which statement indicates that teaching has been effective?

"I need to limit my intake of salt every day." - National dietary guidelines and healthy eating guides limit foods high in salt. Protein should be limited to the 1 gram per kilogram of body weight per day. The guidelines limit foods high in trans and saturated fats. It is recommended for the older adult to consume five servings of fresh fruit and vegetables each day.

The nurse is caring for an older adult client who is prone to developing constipation. The client asks; "What can I do to prevent this from happening?" Which recommendation(s) will the nurse make? Select all that apply.

"Increase the amount of water you drink each day." "Get exercise each day." "Eat more fruits and vegetables."

An older adult reports that the dentures are rubbing against the gums and causing discomfort. The client is not wearing the dentures at all now and states it will be too expensive to buy another set. What is the nurse's best response?

"Sometimes dentures can be lined to ensure a proper fit" - Poorly fitting dentures need not always be replaced; sometimes they can be lined to ensure a proper fit. Eating soft foods is important, but this response does not address the financial concern of replacing the dentures and is not the best solution for the long term due to possible nutrient deficiencies of a soft food and liquid diet. Wearing ill-fitting dentures is an aspiration risk. The client should clean the dentures, but this does not help the fit.

A 78-year-old client states eating 3 full servings of fruits and vegetables per day. What is the nurse's best response?

"You should incorporate at least 2 more servings into your diet."

Feverfew interacts with

Feverfew interacts with salicylates and anticoagulants to cause increased antithrombotic effects.

The nurse is assessing an older adult client's food journal after receiving education to help the client to gain weight. When reviewing the client's entries, what information demonstrates the client has implemented the teaching provided?

Five to six small meals per day noted. - An older adult who is experiencing weight loss should be instructed to eat five to six small meals a day, providing a regular caloric intake without getting overfull. Eating less meals, or meals that are too large may prevent eating on a regular basis that will promote weight gain.

Kava-kava interacts with

Kava-kava interacts with central nervous system depressants to cause increased sedation.

A nurse is assessing an older adult client who has been admitted to the long-term care facility. Which finding would the nurse interpret as a potential pathological process rather than a normal age-related change?

Red and swollen gums

The nurse is caring for an unresponsive client who wears partial dentures. Which action will the nurse take to provide oral care for this client?

Remove dentures, brush teeth and dentures daily.

The nurse is assessing the oral cavity of an older adult client with xerostomia. Which assessment findings require further follow up by the nurse? Select all that apply.

The client exhibits sore, swollen gums. The client has malodorous breath.

An older adult client enjoys eating coffee cake and candy throughout the day. For which potential health problem should the nurse plan interventions for this client?

Tooth decay - An excessive intake of sweets can cause tooth decay. An excessive intake of sweets is not associated with diarrhea, constipation, or hypertension.

The nurse is caring for a client 1 month after a cerebrovascular accident. Which assessment will the nurse perform first?

gag reflex - a weak gag reflex increases the clients risk for aspiration

Garlic interacts with

interacts with Warfarin sodium and aspirin to cause increased antithrombotic effects.

Why would someone go to a registered dietician?

registered dietician addresses nutritional status, identifies and addresses risks, and establishes a nutritional plan of care for the client

Why would someone go to a rehabilitation therapist

rehabilitation therapist specializes in addressing conditions that affect eating and recommends adaptive equipment

The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination?

serum albumin level 2.8 g/dL (28 g/L) - A clinical sign of malnutrition is a serum albumin level below 3.5 g/dL (35 g/L). Other clinical signs include a hematocrit level below 35% (0.35) and hemoglobin level below 12 g/dL (120 g/L).

An adult child caring for an older adult parent calls the nurse, stating concern about the parent's chronic bad breath and stubborn plaque on the teeth. Which teeth-cleaning measure should the nurse recommend for this older adult?

"An manual toothbrush is most effective when giving oral hygiene." - The use of a toothbrush is more effective than swabs or other soft devices in improving gingival tissues and removing soft debris from the teeth. Lemon-glycerin swabs dry the oral mucosa and contribute to tooth enamel erosion. Mouthwashes with high alcohol content can be too harsh for the mouths of older adults.

The nurse is preparing to facilitate a referral for an older adult client with dysphagia. To which member of the multidisciplinary team will the nurse place the referral?

Speech-language therapist with a specialty in addressing dysphagia

An 80-year-old client who has just spent 2 days at the beach with the family is demonstrating confusion and has concentrated urine. Which action will the nurse take?

Administer fluids

Although caloric need decreases with age, nutrient requirements are relatively consistent across the life span. Older adults do not have increased caloric and nutritional needs. Older adults, who are sick, do not necessarily require more calories because the basal metabolic rate declines 2% for each decade of life after age 25. Vitamin and mineral supplements for older adults are undetermined.

Although caloric need decreases with age, nutrient requirements are relatively consistent across the life span. Older adults do not have increased caloric and nutritional needs. Older adults, who are sick, do not necessarily require more calories because the basal metabolic rate declines 2% for each decade of life after age 25. Vitamin and mineral supplements for older adults are undetermined.

The nurse suspects that an older adult's diarrhea is related to medications. Which medication should the nurse consider as causing this client's problem?

Ampicillin - Ampicillin is identified as having the potential to cause diarrhea. Codeine is identified as having the potential to cause constipation. Prednisone is identified as having the potential to cause fluid and electrolyte disturbances. Propranolol is identified as having the potential to cause anorexia.

A smooth red tongue can be an indication of

An iron, B12, or niacin defiency The nurse should perform a nutritional screening

An older client is experiencing hemorrhoids and flatus. Which intervention(s) will the nurse include in the plan of care? Select all that apply.

Avoid foods that cause gas. Teach the client to use a Sitz bath. Apply topical medication as prescribed. Administer stool softener as prescribed.

An older adult client is prescribed a thiazide diuretic as treatment for mild right-sided heart failure. Which herbal supplement should the nurse instruct the client to avoid while taking this medication?

Cascara sagrada - Cascara sagrada interacts with thiazide diuretics to cause an increased loss of potassium.

After reviewing a client's list of medications the nurse asks if the client ever experiences a dry mouth. Which medication on the list caused the nurse to ask the client this question?

Diuretic - can affect salivation and can cause dry mouth

The nurse is caring for a client who is diagnosed with xerostomia related to age-related decline in saliva production. Which intervention will the nurse implement for this client?

Suck on hard candy during the day.

A 78-year-old client reports heartburn on a regular basis after eating. Which topic will the nurse include in the teaching plan?

Eat smaller meals - Regular heartburn can be a sign of gastrointestinal reflux. The nurse will refer the client to the health care provider. In the meanwhile, the nurse will recommend the client eat small meals that are easier to digest and require less stomach acid. Including milk or wine with meals or laying down may exacerbate the symptoms.

During an examination, the nurse determines that an older adult client has a weak gag reflex. Which nursing intervention will the nurse include in the plan of care for this client?

Elevate the head of bed for 30 minutes after eating.

An 88-year-old client asks the nurse how to treat chronic constipation. Which intervention will the nurse recommend for this client?

Increase fluid intake - The nurse will advise the client to increase fluid intake, because a diet with a reduced food and fluid intake is a cause of constipation. The nurse will recommend a diet high in fiber, rather than one with simple carbohydrates, because a diet low in fiber is also a known cause of constipation. The use of suppositories and enemas would be used as a last resort in extreme cases of constipation, because they can lead to dependency.

An older adult client with a history of renal failure is admitted with dehydration and hyponatremia. The nurse identifies which assessment finding(s) as being consistent with the client's diagnosis of dehydration? Select all that apply.

Increased blood urea nitrogen (BUN) Confusion Decreased skin elasticity

After teaching an unlicensed assistive personnel (UAP) about how to feed an older adult client with dysphagia, the nurse determines that the teaching was successful when the UAP identifies which action as appropriate?

Make sure client is sitting upright whenever they are eating or drinking

The nurse notes that an older adult client experiencing weight loss has several missing teeth and the remaining teeth have evidence of gum erosion. Which intervention will the nurse include in the plan of care?

Order a soft diet - The nurse will order a soft diet so the client can eat nutritious food that is easily on the mouth. Oral care is important but lemon glycerin swabs may cause burning in the mouth. Limiting sugar is not a requirement but the client should eat nutritious meals, due to weight loss the client should be weighed at least weekly to determine progress to goals.

An older adult client reports having a dry mouth after being diagnosed with thrush. Which recommendation will the nurse make to this client?

Rinse mouth with warm saltwater - will soothe the mouth and stimulate saliva production - The action of eating certain foods does not increase salivation. It is the action of chewing or sucking on foods such as a popsicle that causes salivation to increase.

The nurse is developing a plan of care for a 75-year-old male client who has had a myocardial infarction (MI). When reviewing the client's medical record, which factor(s) would the nurse identify as increasing the client's risk for constipation? Select all that apply.

Significant activity reduction Administration of several doses of morphine since admission Minimal fluid intake since admission

An older adult client has just been fitted with new dentures. What should the nurse emphasize when teaching about the care of the dentures? Select all that apply.

Soak the dentures in water Clean the dentures every day Remove the dentures each night Clean the gums before applying the dentures

The nurse observes the unlicensed assistive personnel provide mouth care to an older client. For which observation should the nurse intervene?

Swabbed the lower back molars with lemon-glycerin swabs - Lemon-glycerin swabs dry the oral mucosa and contribute to tooth enamel erosion. They should not be used. The use of a toothbrush is more effective in improving gingival tissues and removing soft debris from the teeth. Mouthwashes with high alcohol content can be too harsh for older mouths; diluting a commercial mouthwash with water (half and half) is recommended.

The family of an older adult client with dysphagia comes to the skilled nursing facility to feed the client. Which practice from the family would the nurse address with teaching related to dysphagia?

The family introduces large pieces of food to prevent accidental inhalation of small food particles. - For clients with dysphagia, smaller pieces of food are preferable. Not talking while eating, checking for pocketing, and using the high-Fowler position are appropriate when feeding a client with dysphagia.

The nurse is teaching a class to older adults about oral health practices. What health promotion activity should the nurse recommend?

Visit a dentist every 6 months to detect oral diseases

An older adult client has a history of a deep vein thrombosis. The client should be taught to avoid excessive intake of which vitamin or nutrient?

Vitamin K - High doses of vitamin K can result in the formation of blood clots. Excess vitamin D can result in calcium deposits in the kidneys and arteries. Calcium in excess can lead to kidney stones. Excess potassium can lead to cardiac abnormalities.

Thrush

a fungal infection in the mouth and/or throat caused by Candida albicans and manifesting as white patches and ulcers

During a home visit, the nurse observes an older client place prepared food on a plate for dinner. Which observation indicates that additional teaching is required?

beef steak 50% of the plate, green beans 25%, potato 25% - When using the modified MyPlate for older adults, protein should be one-quarter of the plate. The steak is too large for the serving. Vegetables and fruits should take up half of the plate. Grains should take up one-quarter of the plate. A variety of fluids are recommended for the older adult.